title: Temporal variation in pediatric supracondylar humerus fractures requiring surgical intervention.
abstract: BACKGROUND
  Pediatric supracondylar humerus fractures commonly require surgical intervention and hospital admission, which is costly and consumes significant health care resources. There are few data regarding temporal characteristics (month, day and hour of injury) of this particular pediatric fracture. We wished to investigate the month, day of the week, and time of occurrence of these fractures to guide appropriate use of health care resources and prevention strategies.
  
  
  METHODS
  This study was a retrospective review of clinical records and radiographs of 353 children with operative supracondylar humerus fractures in a temperate climate region over 6 years. Date and time of injury and demographic data (gender, age, laterality) were extracted. Variation in month, weekday, and time of injury was analyzed using circular analysis, cosinor analysis, probability distributions and topographical distribution.
  
  
  RESULTS
  There was a statistically significant increase in the number of fractures during the summer with a peak in early July. When analyzing by month and day of the week, a peak was seen Thursday-Saturday during May-July and middle of the week September-October. Weekdays demonstrated a higher proportion of fractures occurring in the morning and at school. The injuries occurred in the am in 37 and the pm in 241; detailed data were known in 227 with 37 between 0000 and 1159, 51 between 1200 and 1559, and 139 between 1600 and 2359 h. The peak time of injury was 1800 h.
  
  
  CONCLUSIONS
  The increase in supracondylar humerus fractures in the spring through autumn in temperate regions indicates that education campaigns reinforcing fall prevention and landing surfaces should be done in the early spring. The hourly data support the need for dedicated early morning operating rooms to care for these fractures.
  
  
  METHODS
  Prevalence study, retrospective cohort, Level II .
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Indiana University, Indianapolis, IN USA ; James Whitcomb Riley Children's Hospital, Room 4250, 705 Riley Hospital Drive, Indianapolis, IN 46202 USA.
authors.forename: Randall T
authors.initials: RT
authors.lastname: Loder
authors.forename: Emily
authors.initials: E
authors.lastname: Krodel
authors.forename: Kelly
authors.initials: K
authors.lastname: D'Amico
keywords: Month; Supracondylar humerus fracture; Surgery; Time of injury; Weekday